子宫内膜癌组织中叶酸受体α与CA125的表达及相关性研究

发布时间：2018-05-31 15:11

本文选题：叶酸受体α + CA125　；参考：《南方医科大学》2017年硕士论文

【摘要】：研究背景子宫内膜癌是发生在子宫内膜的一类上皮性恶性肿瘤,其发病率在一些欧洲发达国家已居于女性生殖道恶性肿瘤首位。近年发病率在世界范围内呈上升且年轻化趋势,其病因及发病机制未完全明确,治疗仍无突破性进展,术后生存率仍有待提高。目前,子宫内膜癌的诊断主要依靠症状、超声、诊刮术、肿瘤标志物等辅助检查。诊断性刮宫为最常见而有价值的诊断方法。为提高子宫内膜癌患者的生存期及生活质量,早发现、早诊断并尽早干预是关键。近期,有报道指出,叶酸受体α(FRA)在大部分子宫内膜癌组织中呈高表达,有望成为新的肿瘤标志物。FRA是一种糖基磷脂酰肌醇偶联蛋白,在正常组织中表达极低,但在上皮性恶性肿瘤细胞表达明显上升。正因为这一表达差异及特异性,使之有望成为新型生物标志物,协助肿瘤的诊断、监测及预后判断。本研究团队前期研究发现,子宫内膜癌患者血清FRA表达显著升高,那么,FRA在子宫内膜癌组织中的表达及意义如何?CA125是最常见的妇科肿瘤标志物,现已被广泛用于泌尿生殖系统、消化系统等肿瘤的诊断和追踪。目前,对于CA125在子宫内膜癌中的表达研究多局限于血清学方面,然而大多数学者认为血清CA125水平并不能准确反应肿瘤的进展程度。那么CA125在内膜病变组织中表达如何?其与FRA是否存在相关性?对临床诊断及预后判断是否存在意义?目的通过检测不同内膜病变组织中FRA、CA125的表达差异及与临床病理特征的关系,探讨FRA在子宫内膜癌变过程的临床意义及可能的机制,分析FRA与CA125的相关性,探讨两者对临床诊断及预后判断的意义。方法收集子宫内膜腺癌标本60例,随机选取子宫内膜增生症46例及正常子宫内膜10例,采用免疫组化法检测组织中FRA、CA125的表达。阳性染色为细胞膜及细胞质中呈现棕黄色或棕褐色颗粒,与阴性表达的比较。结果1、FRA在正常子宫内膜、子宫内膜增生症及子宫内膜癌组织中均可见表达,阳性率分别为10.0%、45.7%、93.3%,且在内膜癌中呈高表达(65.0%),较增生症组和正常组升高(P0.05)。2、复杂型子宫内膜增生组织中FRA的阳性率较单纯型升高,伴不典型增生较其他类型表达率升高(P0.05);内膜癌组中,FRA的表达与年龄、FIGO手术病理分期、分化程度有关(P0.05)。3、CA125在正常子宫内膜组织中以低表达为主,在增生症及内膜癌组织中则以高表达为主。FRA及CA125在子宫内膜癌变过程中呈弱正相关关系(r=0.204,P=0.028)。结论1、子宫内膜从正常增殖到增生、出现不典型增生继而癌变,组织中FRA的表达呈逐步上调趋势,提示FRA可能参与到子宫内膜病变甚至癌症发生当中;FRA作为一种新型生物标志物,为子宫内膜癌的靶向诊断提供理论基础。2、子宫内膜癌中FRA的表达较非癌变组织明显增高,且与肿瘤的分化、分期相关,提示FRA有望成为子宫内膜癌新的治疗靶点。3、FRA与CA125在子宫内膜癌变过程中均呈上调趋势,两者联合用于诊断子宫内膜癌的效果优于单一指标。
[Abstract]:Background endometrial carcinoma is a kind of epithelial malignant tumor occurring in the endometrium. Its incidence is in the first place in some European developed countries. In recent years, the incidence of cancer is rising and young in the world. Its etiology and pathogenesis are not completely clear, and the treatment is still without breakthrough. The survival rate remains to be improved. At present, the diagnosis of endometrial cancer is mainly dependent on symptoms, ultrasound, curettage, and tumor markers. Diagnostic curettage is the most common and valuable diagnostic method. To improve the survival and quality of life of patients with endometrial cancer, early detection, early diagnosis and early intervention are the key. The expression of folate receptor alpha (FRA) is highly expressed in most endometrium cancer tissues and is expected to become a new tumor marker,.FRA, a glycosylphosphatidyl inositol coupling protein, which is very low in normal tissues, but in epithelial malignant tumor cells. Biomarkers to assist in the diagnosis, monitoring and prognosis of cancer. Earlier studies of this team found that the expression of FRA in endometrial cancer patients increased significantly. Then, how is the expression and significance of FRA in endometrial carcinoma? CA125 is the most common gynecologic tumor marker and is now widely used in the genitourinary system and in the digestive system. Diagnosis and tracking of tumors. Currently, the expression of CA125 in endometrial cancer is mostly confined to serology. However, most scholars believe that serum CA125 levels do not accurately reflect the progression of cancer. Then how does CA125 express in endometrial tissue? Is there a correlation with FRA? Clinical diagnosis and prediagnosis To determine the significance of post judgment? Objective to explore the clinical significance and possible mechanism of FRA in the process of endometrial carcinogenesis by detecting the difference in expression of FRA and CA125 and its relationship with clinicopathological features in different endometrium tissues, and analyzing the correlation between FRA and CA125, and exploring the significance of the two methods for the diagnosis and prognosis of the endometrium. Method collection of methods. 60 cases of endometrial adenocarcinoma were selected, 46 cases of endometrial hyperplasia and 10 cases of normal endometrium were randomly selected. The expression of FRA and CA125 in tissue was detected by immunohistochemistry. The positive staining showed that brown or brown brown granules in the cell membrane and cytoplasm were compared with negative expression. The results were 1, FRA in normal endometrium and endometrial hyperplasia. The positive rates of the endometrial carcinoma were 10%, 45.7%, 93.3%, respectively, and high expression in endometrial carcinoma (65%), higher than that of the hyperplasia and normal groups (P0.05).2. The positive rate of FRA in the complex endometrium hyperplasia was higher than that of the simple type, with the increase of other types of atypical hyperplasia (P0.05), and the endometrial carcinoma group. The expression of FRA was associated with age, pathological staging of FIGO, degree of differentiation (P0.05).3, CA125 was mainly low in normal endometrium, and high expression of.FRA and CA125 in hyperplasia and endometrial carcinoma tissues were weakly positive (r=0.204, P=0.028) in the process of endometrial carcinogenesis (r=0.204, P=0.028). Conclusion 1, endometrium increased from normal. The expression of FRA in tissue is gradually up-regulated, suggesting that FRA may be involved in endometrial lesions and even cancer. As a new biomarker, FRA provides a theoretical basis for the target diagnosis of endometrial cancer, and the expression of FRA in endometrial carcinoma is more than that of non cancerous tissue. Xian Zenggao, which is associated with tumor differentiation and staging, suggests that FRA is expected to be a new therapeutic target for endometrial cancer,.3. Both FRA and CA125 are up-regulated in the process of endometrial carcinogenesis, and the combination of both of them in the diagnosis of endometrial cancer is superior to that of a single index.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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